Posted by Elizabeth on August 3, 2001, at 18:49:20
In reply to This is going too far, posted by Else on July 31, 2001, at 7:14:58
> Excuse me but I must object to that. Antipsychotics, even atypical, still have many unpleasant neurological side-effects and are still potentially dangerous in the long run (the risk of TD may be decreased but it is not eliminated, look at the PDR). They are not first line treatment for anxiety disorders, which can benefit from less toxic drugs that have been used for longer and/or have a lower incidence of side effects and/or cause less sedation.
I'd add that antipsychotics generally do not work for panic disorder. And dopamine antagonists make a lot of depressed people feel *worse*, not better.
> I am really against the idea of antipsychotics becoming first-line treatment for every mental illness under the sun.
Me too. I'm aware that they do work (mainly in low doses and in combination with antidepressants) for some people with certain types of depressive symptoms, but they're far from being a reasonable first- (or even third-) line treatment.
> My brother was put on Risperdal because he was a bit hysterical, but not psychotic. He said he felt absolutely horrible on it.
His experience is not unique. A lot of people who aren't actually psychotic feel very crappy on these drugs.
My feeling is that medication treatment should be tailored to the individual -- I doubt that there is really a "short list" of drugs that are the most effective for all types of depression.
And medication treatment doesn't have to be luck of the draw. I decided to try desipramine because I know that TCAs are the treatment of choice for my type of depression. The only reason I'd never gotten through an adequate trial of a tricyclic was that I hadn't tolerated them; now I've found out that this might be the result of inadequate metabolism (resulting in very high serum levels). There are some types of depression that tend to be nonresponsive to TCAs; for some people, TCAs can even make their depression worse. These people are more likely to benefit from SSRIs, MAOIs, and perhaps stimulants, mood stabilisers, or atypical antipsychotics as augmentors.
-elizabeth
poster:Elizabeth
thread:72332
URL: http://www.dr-bob.org/babble/20010731/msgs/73416.html